Maurice A. Ramirez, DO, CNS, CMRO

InstaDecision: 4 Steps to a "Blink" Moment

The past months have seen a resurgence of interest in the ideals of “gut reactions,” intuition and other versions of the insight methods described by Malcolm Gladwell in “Blink!” Business leaders, CEO’s, physicians, disaster field responders, professional speakers and a business consultants use both linear and non-linear decision making (logic & intuition) to create “Blink” moments daily.

Most people know the linear decision making process because t is cultivated by our educational system. It is a system based on the collection of data to support a decision (If A and B then C, but if A and not B then D). Few people realize that we are all born as innately non-linear thinkers.

What Goes Into a “Blink” Moment?

Non-linear process is a four step process consisting of:

1) Pattern Recognition

2) Acknowledging Framing Bias

3) Heuristic Introspection

4) Empathy

Pattern Recognition

Pattern recognition is seeing the patterns and processes behind everything you do and have done. Remember that those with the greatest potential are those who are the most adaptable to any circumstance. They innately understand the process that underlies any other person’s success and can replicate it with ease.

Acknowledge Framing Bias

Think about what happens before a manager goes into a meeting. Rarely will people walk into the situation “cold.” They are briefed on who they’re going to meet and what they’re supposed to accomplish. They draw certain preconceptions, which is called a framing bias.

As long as you know what your framing bias is upfront, then you can allow the situation to develop organically. You can then take away your feelings and your impressions and use them as an analytical tool. That’s the essence of heuristics—taking your feelings and impressions and using them analytically.

Before you can fully immerse yourself in another’s viewpoint, you need to shed your framing bias. First, identify what your preconceptions are about the situation. Second, once you’ve identified them, clear your mind and explore the experience for the first time. What’s your first impression? Are you reacting the way you are because of your preconceived ideas or because you are looking at the situation through fresh eyes?

Heuristic Introspection

Heuristic introspection is a non-linear thought process in which you must “be your customer”. Much like how a fine artist “knows” if a painting or musical composition “works” by going with their “gut,” your employees should “know” what a customer wants.

When you think heuristically, you truly understand the customers’ wants and needs. The next time you want to know how your customers would feel about a particular product or service, adapt a non-linear (heuristic) research approach and become a part of your study base. Your focus group of one (you) will guide your initial thought process toward reaching your customers.

Empathy

Empathy is quite literally to walk a mile in the shoes of our customers, that is to become one with your customers. Become part of the story, even if you aren’t part of the product story. Generally, people like and dislike the same things. If not, you’d never have to wait in line for your favorite roller coaster at an amusement park. What do you feel? Listen to your gut—chances are your customers’ gut would tell them the same thing. You may not identify with the problem, but you’ll know what you need to do to make it feel “right.”

How can you now translate what you’ve discovered into a reproducible decision?

If you’re developing an ad for jogging shoes, you need to think like a runner—even if you’re not one. Why do people run? What is important to runners? How does running make people feel? After you’ve collected your personal research, you’ll be able to speak in the first person as a runner. Pretend you’re one of those successful fiction authors writing under a pseudonym. Tell your story like you live it. Now your customers will be able to personally connect with you because you’ve become one of them.

Why do people underestimate the power of this?

There are two reasons that nonlinear decision making and inductive reasoning are less valued than linear decision making and deductive reasoning. Both are based on the misperception that nonlinear decision making and inductive reasoning are inherently irreproducible, unverifiable, unpredictable and thus unreliable.

1)     Despite that fact that humans are born as empathic, introspective and unbiased "pattern recognition machines," the vast majority become linear deductive decision makers. Through their educational experiences and the very basis of our scientific society, deductive is valued over inductive and linear over nonlinear.

2)     Once the nonlinear and inductive skills are atrophied, those that undervalue what they can no longer do easily (nonlinear decision making) believe that these skills are unlearnable. Nothing could be further from the truth.

Pattern Recognition is an innate human function that ensures our survival in infancy and aids in our safety in daily living. It is easily taught and augmented.

Acknowledging Framing Bias is not an innate function, but is very learnable and since it does not require the shedding of bias, is also readily implemented.

Heuristic Introspection is partially innate. All humans are born with a degree of introspection especially when dealing with ones own needs. Walking in the shoes of another is not an innate behavior, but understanding our reaction in that situation and using that information is trainable.

Empathy is yet another innate function that ensures our ability to identify and even predict the emotional impact of an event on others. Empathy is a practiced skill and the strength of one's empathy grows as one exercises that empathy.

In short the problem is not that "gut" is unreliable or "sample size of one" (intuition) is too small. The problem is in those who devalue this innate human ability.

"The fault lies not in our stars Horachio, but in ourselves."

-          William Shakespeare

Outrage or Enthusiasm: The Choice is Yours!

Businesses large and small want happy customers, happy employees and happy vendors. Regardless of whether a multinational corporation or a “Mom & Pop” store, enthusiastic supporters are a marketing asset while a single outraged person is a liability. Studies have shown that the average “satisfied customer” refers five people while the average “dissatisfied customer” finds 11 people to chase away.

Businesses and whole industries spend huge sums of money meeting customer expectations and even larger sums of money raising those expectations further. It is a never ending chase and if you lose, twice as many people will hear from the disappointed than ever heard from the content.

The key then is to manage the factors that determine the satisfaction of customers, employees and vendors with their experiences interacting with a business.

Let Your World PIVOT Around Them!

When people are born, they believe that they are the center of the universe. As children grow and mature into adulthood, they slowly learn that the world does not revolve around them. Businesses seek as part of their customer service approach to make customers feel that again the world revolves around them. Rather than reverting to childhood, a business seeking enthusiastic supporters should make the experience PIVOT around them.

The PIVOT model provides a simple mathematical approach to understanding and even predicting the societal and individual response to an experience. The PIVOT model is another lesson learned from the disaster field office. PIVOT stands for:

P = Probability

I = Impact

V = Vulnerability

O = Outrage

T = Tolerance

Each component of the PIVOT model places a numerical value on the factors that determine the response to the experience a business provides. It is a predictor of “Customer Satisfaction.” To apply the PIVOT model each component must be understood.

Probability

Probability = The likelihood of an experience occurring (0% to 100%)

Drawn from traditional risk management and actuarial sciences, the probability of an experience or event occurring is a value based on the historical frequency of an experience or event occurring. Most simply, probability is the number of times an experience or event occurs divided by the total number of possible experience and events.

Impact

Impact = The impact of an experience (positive or negative) on a scale 0 to 3

(0 = No Impact; 1 = Minimal Impact; 2 = Moderate Impact; 3 = Significant Impact)

It is often said that no event or experience is without impact, but assigning a value to the degree of impact is often complicated. The PIVOT model deals with response to an experience or event and is inherently subjective, thus Impact is a subjective measure based on past occurrences of the experience or event.

Vulnerability

Vulnerability = The susceptibility to the impact on a scale 0 to 3

(0 = None; 1 = Minimal; 2 = Moderate; 3 = Significant)

Like Impact, Vulnerability is a historically based, subjective measure of the susceptibility to the Impact. Obviously, if something has occurred previously but had not Impact, the Vulnerability is zero; however, when an Impact has occurred in the past, people have an inherent and subjective sense of Vulnerability which can be subjectively measured.

Outrage

Outrage = The perception of the experience on a scale -3 to 3

Outrage was first identified as a component of risk communications by Paul Sandman, PhD. In his model, Sandman identified two factors that influenced and predicted the need for risk communications in the event of a business debacle, Hazard & Outrage. Sandman found that while a high perceived Hazard necessitates risk communication, low Outrage mitigated that need while high Outrage necessitated risk communication even with a low perceived Hazard.

Sandman never quantitated the level of Outrage, but in the PIVOT model, Outrage is a calculated value. Calculation of Outrage requires an understanding of two additional values, Expectation and Satisfaction.

Expectation = Perception of what reality SHOULD BE on a scale 0 to 3

(0 = None; 1 = Minimal; 2 = Moderate; 3 = High)

Satisfaction = Perception of what reality ACTUALLY IS on a scale 0 to 3

(0 = None; 1 = Minimal; 2 = Moderate; 3 = High)

Understanding Expectation and Satisfaction, Outrage can be calculated:

Outrage = Expectation – Satisfaction

The interesting result of calculating Outrage is the insight this provides. Since Expectation is the perception of what reality should be and Satisfaction is the perception of what reality actually is, and given that a business cannot change people’s perception, Outrage is actually the difference between Expectation and REALITY.

Tolerance

Tolerance = The sentiment regarding the experience or event.

Tolerance is the measure degree of Enthusiasm or Anger in response to an experience or event and like the calculation of Outrage, calculating Tolerance gives tremendous insight into why seemingly bad business news results in good while seemingly good business news can become a full fledged business disaster. To calculate Tolerance, first calculate Hazard and Risk.

Hazard = Impact + Vulnerability

Risk = Probability x Hazard

        = Probability x (Impact + Vulnerability)

Having previously calculated Outrage and now having quantitated Risk, Tolerance is simply calculated, noting that if Outrage is a negative number, the positive number (absolute value) is used to calculate Tolerance.

Tolerance = (Risk)^|Outrage|

Therefore Tolerance (anger or enthusiasm) equals Risk raised to the power of Outrage.

Choosing Epidemic Enthusiasm

A look at two classic historical business examples demonstrates how accurate and powerful the PIVOT model is for influencing public and individual sentiment.

McNeil Pharmaceuticals is the textbook example of risk communications after the cyanide contamination of their Tylenol product. Applying the PIVOT model, the probability of dying from a contaminated pill 100% and the impact if such an event occurred and the vulnerability were both high thus each scoring 3 points. Calculating for Hazard and Risk yields a Hazard score of 6 with a Risk score of 6. The Expectation of the general public was also high (3 points) as there had never before been a significant problem with a McNeil product.

When the company responded by publically withdrawing the product from the market and pledging to not return to store shelves until safety could be assured, Satisfaction was moderate (2 points). But, when McNeil made good on their promises, Satisfaction was high (3 points). Outrage, which could have crippled the company’s return to the marketplace, was effectively reduced to zero.

When Outrage is zero (Expectation = Satisfaction), the Tolerance score always equal to 1. (Mathematically, any number raised to the power of zero equals 1).

The textbook contrast to McNeil / Tylenol is New Coke / Classic Coke. The Coca-Cola Company dominated the cola market for decades when market research began to show that Pepsi cola was eroding a small percentage of Coke’s market share. In a carefully researched and planned effort to regain that small market share loss, the Coca-Cola Company reformulated Coca-Cola. Again applying the PIVOT model, the probability of bringing the new product to market was 100%, but market research and focus groups had found that the Impact would be minimal (1 point) although the Vulnerability to the Impact moderate (2 points). Calculating or Hazard and Risk yields a Hazard score of 3 and a Risk score of 3.

When the new formulation arrived on store shelves, Expectation was high (3 points), but Satisfaction with the new formula was nonexistent (0 points). The Tolerance score of 27 predicts what followed. Consumers began to hoard “old Coke” and picket against “New Coke.” Re-examining the anticipated Impact and Vulnerability shows that loyalty to the taste of the “old Coke” formula meant that the both Impact and Vulnerability were actually each 3 points, thus Hazard was 6, Risk was 6 and Tolerance was 216 (highest possible score). Despite the reintroduction of “old Coke” as “Classic Coke,” it was years before the Satisfaction score rose and the Tolerance score exponentially fell.

When Outrage is a positive number (Expectation > Satisfaction), the Tolerance score is a reflection of the Anger (negative image) felt towards the business.

But this is not the end of the New Coke / Classic Coke story. An unintended, but not unexpected beneficiary of the Coca-Cola Company’s misstep was Pepsi cola. Regardless of the success or failure of the new Coca-Cola formulation, the probability of the product making to store shelves was 100%. Had Coca-Cola’s market research been correct, the Impact on Pepsi cola would have been high (3 points) and as the number two product in the marketplace, Pepsi’s vulnerability was also high (3 points). Pepsi cola had a lot riding on Coke’s reformulation with a Hazard score of 6 and a Risk score of 6.

When “New Coke” disappointed Coke consumers, Pepsi consumers were heartened by the fact that Pepsi was NOT being reformulated. The Expectation for a change in flavor was nonexistent (0 points) while Satisfaction remained high (3 points). For Pepsi cola, the Outrage score was negative (-3) yielding a Tolerance score of 216, but unlike Coca-Cola customers, Pepsi customers were predictably enthusiastic about their preferred product. Same event, same reality, different outcome based on perspective and expectation.

When Outrage is a negative number (Satisfaction > Expectation), the Tolerance score is a reflection of the Enthusiasm (positive image) felt towards the business.

Manage What is Manageable

Ultimately, Probability, Impact, Vulnerability, Perception and Reality cannot be changed. Of all the factors that determine public and individual sentiment and predict anger verses enthusiasm, Expectation is the only factor that can be changed before and to a lesser degree during an event or experience. Thus if Expectation can be preemptively made to matched reality, Outrage is changed. Through expectation management, Anger is downgraded to Concern; Concern is converted to Opportunity; and Opportunity is upgraded to Enthusiasm.

Limited Resources and Ethics

Please discuss the ethical challenge of dealing with limited resources in a mass disaster.
(Question posed via: Ask@MauriceARamirez.com)

The importance of dealing ethically with people in times of limited resources deals not only with mass disaster, but business continuity and even daily business operations. Whether the limited resource is food water, and medical care in a disaster or wages, shifts and benefits in a business down turn a goal oriented decision process must be employed.

In a mass casualty event, Continuous Integrated Triage should be employed to determine who receives care now and who waits for care based on degree of injury balanced against resources available.

To maximize the delivery of products and services during a time of scarcity, Business Triage must be applied, even by non-healthcare enterprises.

The need for triage is not an opinion, but the consensus of the vast majority of experts in crisis management, healthcare and business continuity. To determine the ethics of such an approach, several ethics boards were asked to address the issue.

Dr. Mark Pastin, President of Health Ethics Trust believes that the need for triage is the, “simple and obvious answer.” Dr. Pastin points out that there is the “risk of violating what would ordinarily be viewed as your professional responsibilities if you do triage.” Dr. Pastin posed the example of an existing doctor-patient relationship with one of the casualties. Dr. Pastin, a long time advocate for resource based standards of care in disaster healthcare points out that the lack of such standards leaves an array of questions should the care available fall below the usual standard of care. Dr. Pastin also points out that some have even wondered if euthanasia might be appropriate to those who are suffering but not likely to be treated.

Ethicist Dr. Ken Solis finds that the distribution of limited resources equitably or most effectively is sometimes “opposing priorities.” Dr. Solis observes that “most disaster plans, for example, allocate a limited resources to health care workers (and their families so the health care worker is willing to show up at work), safety officials (police, firemen/women), and public officials to keep critical infrastructures operating and so that more subsequent people can be treated - a utilitarian or effectiveness approach. After that, most models go by ‘first come-first serve’ or ‘lottery’ to try to be equitable.   Of course, those with the most means will still tend to come in earlier due to their greater resources and might even be able to cheat the lottery in some way, e.g. pay a poor person a lot of money for their ‘ticket’."

Dr. Pastin and Dr. Solis agree that, in a disaster situation, some of the norms that guide the typical provider-patient relationship will undoubtedly become difficult to sustain. The 2001 anthrax attacks and subsequent fear resulted in behavior by physicians and other healthcare providers that culminated in a nationwide shortage of Cipro (ciprofloxin) and doxycycline.

Dr. Solis echoes the concerns of many both in and out of healthcare when he reminds us of another challenge: the competing interests that a health care worker will have balancing their family versus their patients.  “Some healthcare providers will give priority to their family, especially if their absence could cause their family harm. Similarly, the healthcare provider may decide that their presence at the disaster (e.g. an infectious disease epidemic) could cause their family harm.  During the black plaque in Europe, many doctors fled to the country side, not an effective tactic, but acted based on their personal priority.”

The decisions involved in the triage and resource allocation process will result in dissatisfaction at many levels. While the first principle of medicine for centuries had been Primum Non Nocerum (First Do No Harm), it is increasingly obvious that in disaster healthcare the first principle should be “Do the Most Good for the Most People with What You Have Now.”

An ounce of soap is worth a pound of medication!

I think too often the public’s attention is captured by new medical discoveries while forgetting older methods that have worked well for us for years.

I have not seen any recent articles on the use of probenecid with Tamiflu, or the use of bacteriophages to treat our present MRSA epidemic.

If given my choice, I’d pick a box of masks, gloves and a bar of Dial soap over 10 caps of Tamiflu to avoid the flu.

What are your thoughts on it?

I agree that the industrialized nations of the world as a global  society and medicine as a profession have both become far too dependent on ever escalating doses of medications to solve major public health problems. The great medical philosopher Benjamin Franklin once said, “An once of prevention is worth a pound of cure.” Your masks (in 1918 a handheld cloth handkerchief), gloves and soap will do far more to treat future epidemics and pandemics (influenza, MRSA, SARS, or who knows what) than any pharmacologic agent.

The problems with any pharmacologic solution are side effects, resistance, compliance and prescribing practice. Our current MRSA problem is the direct result of the overuse of antibiotics, especially for “prophylaxis” after low risk lacerations and “treatment” of upper respiratory infections most of which are viral. Add to this the fact that many patients save “left over” antibiotics from prior prescriptions only to use them at a later date thus creating two incomplete treatment periods and bacterial resistance rapidly develops leading to MRSA (and other resistance problems).

Bacteriophages may one day hold the promise of disease targeted treatment, but chaos theory as it relates to mutation and genetics dictates that resistance will eventually develop even to these targeted therapies. The best solution is the oldest, a correct diagnosis linked to a specific and conservative treatment with full compliance to the treatment on the part of the patient.

The use of probenecid to raise the serum levels and area under the curve for Tamiflu (or Relenza) is an interesting theoretical solution to the need for double dose antivirals to treat H5:N1. Unfortunately, the degree of serum level elevation and area under the curve change that would result from probenecid in a given patient is unpredictable. Further, increase serum drug levels, whether from increased dosing or probenecid, will increase side effects including psychosis, depression, suicidality, toxic epidermal necrolysis and Stevens Johnson reactions. Like any pharmacological solution, risk and benefits must be weighed and Ben Franklin’s lesson must be updated for the new millennia...

An ounce of soap is worth a pound of medication!

Question submitted through Ask@MauriceARamirez.com

Identify, Notify, How?

During a recent planning session for a Catastrophic Health Incident Response Plan work shop the problem of victim identification / family notification was identified. What is your solution?

Your question touches on the key issue of priorities during a disaster response, most significantly in the initial hours after an event (when resources and information are most limited). Given the limited resource environment, any solution must conform to a resource allocation (business triage) model.

Most in disaster and emergency management would agree that the most important goal during the response to an event is the preservation of life. Close behind in importance is the prevention of further loss (preservation of property and resources); then the dissemination of information. Somewhere after these three (and perhaps a dozen more priorities) is the identification of the dead and the notification of families. The problem is that the notification of the families of survivors and the notification of the families of patients is too often lumped into the same priority category with the notification of the deceased. This means that families remain separated from survivors and patients increasing the psychological impact and pain caused by the disaster. Counterbalancing this need to reunite is the fact that the most limited resource in the early hours and days of a disaster response is people. Given the relative priorities of preserving life and mitigating loss, diverting resources to reunification is difficult to justify operationally while it is simultaneously difficult to delay morally.

The most obvious solution is to utilize resources not already dedicated to other early response activities. Unfortunately, untrained volunteers are of little assistance in the notification process and may inadvertently create hardship and confusion with a mistaken notification. Automation of the notification process using systems such as EMSystems, EMTrack, IRIS, or KatrinaSafe.org is less resource (personnel) intensive and in the case of KatrinaSafe.org, requires minimal orientation (great for those volunteers above). The problem with automated systems is that the system must know where to send the information so that the families can find it. EMSystems, EMTrack and IRIS collect information as part of other functions (effectively resource neutral) and send information to the Joint Information Office or the Emergency Operations Center. The JIO and/or EOC then must deal with notification and the resources required for that process. KatrinaSafe.org requires resource utilization to enter the survivor information, but notification is via a computer matching system in which the family enrolls on the internet (effectively resource neutral). The ideal would be some merger of these existing systems such that the already collected information were filtered to KatrinaSafe.org or another similar national system and then matched to the searching families without further resource utilization.

Question Submitted via Ask@MauriceARamirez.com

Antiviral Stockpiles and Prophylaxis

"An organizational decision to stockpile antiviral medication and then acquiring anti-virals is the simplest part of a plan.  The protocol associated with securing, transporting, screening and eventually dispensing the antivirals is another matter altogether. Please comment on some of the antiviral initiatives that you are seeing and give your personal opinion on the use of antivirals as prophylaxis."

There are several issues to consider when dealing with antivirals and pandemic flu. The first deals with the dose, regimen and efficacy of antiviral treatments for pandemic flu. Experience with antiviral regimens against H5:N1 influenza in South East Asia has shown that even with the best healthcare professionals in attendance and the greatest minds guiding care, the usual dose of antiviral medication must be doubled and that the length of time required for treatment is twice as long. Further, the past several months has demonstrated a disturbing trend towards the need for the use of both drugs at this four fold increased regimen. This set of facts alone means that a company planning to stockpile must now plan on four times as much of each drug for each person to be treated.

The second issue deals with obtaining sufficient quantities of both drugs to provide effective treatment. Based on standard doses, experts and governments agree there are insufficient supplies of antivirals available to treat just those in healthcare critical infrastructure and national critical infrastructure roles. The four-fold increase in dose and the need for duel drug therapy effectively reduces supplied eight-fold.

The third issue deals with the ineffectiveness of prophylaxis and the risk of creating resistance to the few drugs we have now. While drug prophylaxis has a certain theoretical appeal, it has not been shown to be effective for influenza. Worse, constant exposure of the disease to low doses of the antivirals increases the likelihood of mutation resulting in resistance to the antiviral drugs. Finally, any drug used for prophylaxis is taken out of the total supply, thus reducing the amount of drug available for treatment. Given that at worst, only one in three people exposed to the disease actually falls ill, giving prophylaxis to everyone means using three times more drug than needed, or running out of drug three times sooner.

The fourth issue deals with the ethics of superseding national needs regarding critical healthcare infrastructure support and national critical infrastructure support. Given a limited worldwide supply of antivirals, such redirection of drug means that some segment of critical infrastructure will be denied treatment.

In short, the decision to stockpile medications is ill-conceived, impractical and quite possibly unethical. Prophylaxis is perhaps the only decision that would be worse.

Question submitted through Ask@MauriceARamirez.com

How do the kids who rely on two meals a day from the schools get fed when the school is shutdown?

Non-pharmacological response plans for pandemic include no only social distancing, but often some combination of school closures, cancelation of mass gatherings and travel restrictions. These last three hold significant financial implications for the communities and society in general. Imagine if you can all shopping malls, concerts, theme parks, conferences and movie theaters being closed down in your area for months at a time. Not only would the economic impact of lost sales be overwhelming to local economies, but the loss of small and even medium sized businesses would lead to the loss of jobs and worse, the loss of employers.

However, not only will there be severe economic impact, but even more dire psychosocial impact. One example is the impact on childhood nutrition. 30.1 million American children depend upon school nutrition programs for one or two meals each day. Unfortunately, many of these children receive no other meaningful nutrition each week. The loss of these 5 to 10 meals per day places all these children at risk. The families who rely on school nutrition programs often lack the financial means and/or know how to provide meals for these children. Current plans at a national, regional, or state level do not account for this and similar issues. The first rule of disaster planning is that all disasters are local, therefore it is up to local emergency managers, local disaster planners and individual families to prepared to feed these children in the event of school closures.

Question submitted through Ask@MauriceARamirez.com

What support can the private sector expect from the U.S. Government during a pandemic?

Question submitted through Ask@MauriceARamirez.com

During a typical disaster related emergency, needs exceed resources in a limited region of the United States. Even disasters on the scale of Katrina are limited in their region of impact. A pandemic by definition will effect the entire nation (and the entire world) simultaneously for a period of 12 to 24 months. The extended time over which the disaster event will exist combined with the fact that there will be no geographical limit to the impact area means that the typical governmental response of shifting resources from unaffected areas to the impact region will not work.

When asked about resource allocation for pandemic, Secretary of Health and Human Services Levitt said, “from where to where?” All pandemic response plans are geared towards supporting critical healthcare and defense infrastructure, followed by critical national infrastructure. With the realization that there is no drug or vaccine regimen that significantly changes the course of disease, the emphasis on a “pharmacological response plan” is being a downgraded in favor of a “non-pharmacological response plan.”

This non-pharmacological response plan depends on concepts of social distancing, personal hygiene, cough hygiene and sneeze hygiene supplementing regional plans for school closures, cancelation of mass gatherings and travel restrictions. Unfortunately, these last three have never been shown to work for large scale zoonotic pandemics. Further, closure, cancelation and restriction plans will negatively impact the private and public sectors economically, but that is tomorrow’s question.

How to Become a Critical Service Provider

The following question was submitted through Ask@MauriceARamirez.com

How do we get assurance from state/local emergency preparedness agency that, in the event of a local disaster get placed on a priority list with the utilities companies (power, water, waste management) and critical service providers (cellular, bottled water, critical supplies)?

The only way to receive priority services is to be a recognized as a provider of critical community response or recovery services. In most cases, these providers are already known to emergency management, but any business capable of contributing to their community’s response or recovery should contact their local office of emergency management to become part of the local response plan and to be added to the local response resource list.

Local companies that provide much needed services, even those not usually considered critical service providers, can be designated such by the local office of emergency management. Once a company is determined to be a critical service provider, that company will be asked to provide the office of emergency management a list of resources needed to continue services and that need triaged against other demands for a given resource.

Happy Thanksgiving 2007

Thanksgiving is a time for taking stock of the blessings we enjoy and the people with whom we share these blessings. It is also a time to give thanks.

Thanks for those we love.

Thanks for those we serve.

Thanks for those we protect.

Thanks for those who protect us.

Today, turn off the computer, log off the blogs, save the emails and enjoy time with those for whom you are giving thanks.

Happy Thanksgiving!

God Bless you all...

and God Bless the USA!